HR7198-119

What This Bill Does

The Ensuring Access to General Surgery Act responds to projected national surgeon shortages and maldistribution, including HRSA findings that rural areas have only 69 percent of the general surgeons needed. It adds a Public Health Service Act section on general surgery shortage areas. HHS, acting through HRSA, must study whether existing health professional shortage area designations accurately measure local access to general surgeons for underserved urban, suburban, and rural populations. The study must assess whether a measure based on general surgeons practicing within hospital service areas would be more accurate, and must consider a methodology using hospitals with surgery services, Medicare patient-origin ZIP Code data, identification of actively practicing general surgeons, general-surgeon-to-population ratios, and threshold ratios for optimal supply, adequate supply, shortage, and critical shortage. HHS cannot assume the current national supply is adequate or optimal and must consider wait times, health outcomes, ground transportation time to the nearest surgical center, critical access hospitals with surgical capabilities but no general surgeon, and patient experience. HHS must consult medical societies, surgical-facility organizations, general surgery experts, and patient organizations, report to Congress within one year, periodically publish Federal Register data comparing availability and need, and may later designate general surgery shortage areas through notice-and-comment rulemaking with annual review and procedures similar to health professional shortage areas.

Who Benefits and How

Underserved rural patients, underserved urban patients, underserved suburban patients, critical access hospitals, hospitals with surgery services, general surgeons, medical societies, patient organizations, and rural health advocates benefit from better data on where general surgery access is inadequate. HRSA and HHS benefit from a statutory pathway to develop general surgery shortage area designations that could guide future workforce policy. Congress benefits from a one-year report and periodic public data.

Who Bears the Burden and How

HHS and HRSA staff must conduct the study, build or test methodology, collect Medicare patient-origin and surgeon workforce data, consult stakeholders, publish Federal Register data, report to Congress, and possibly conduct notice-and-comment rulemaking with annual designation reviews. Hospitals, medical societies, surgical facilities, and patient organizations may need to provide data or consultation. Areas not designated as shortages may receive less policy attention if the methodology is later used for funding or workforce incentives.

Key Provisions

• Requires HHS through HRSA to study whether current shortage designations accurately measure access to general surgeons.
• Requires evaluation of hospital service area, Medicare patient-origin, surgeon identification, and surgeon-to-population ratio methodologies.
• Requires threshold analysis for optimal supply, adequate supply, shortage, and critical shortage of general surgeons.
• Requires consideration of wait times, health outcomes, transportation time, critical access hospitals lacking surgeons, and patient experience.
• Requires stakeholder consultation, a congressional report within one year, and periodic Federal Register publication of access data.
• Allows HHS to create general surgery shortage area designations through notice-and-comment rulemaking and annual review.